Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 16797 | MD |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DEN1001994 | DC |
NPI | 1003294976 |
---|---|
Provider Name | Dr. Michael Choi |
First Address | Washington, DC 20060-0001 |
Second Address | Washington, DC 20060-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2015 |
Last Update Date | 30/06/2019 |